Health Care: To Reform a la Socialists Part Deux: We've Lost the First Battle, But NOT the War
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As you know if you are a regular reader at NewsBusters, we've been discussing this so-called "health care reform" issue for at least seven months, in more than 500 fact-filled and informative posts. You can find that discussion here....and if you are new to this forum topic, I'd suggest you brew a nice pot of coffee, clean your glasses, and reserve a couple of hours to get an education on a myriad of issues surrounding the great health care debate of our time.
As of Saturday, Bela Pelosi and her criminal gang have twisted enough arms and thrown enough money around (Can you say $130 million for your vote, Congressman, for your California medical school? I knew you could!) to pass this abonination of a bill, it's time for us to regroup and figure out what is next on the agenda.
As with the first forum, this is a serious subject for serious people. All are welcome, but trolls are not, nor will trollishness or thread-derailing, flaming, or name-calling be tolerated.
As a couple of starting points....What are the true outrages in this bill? (Yes, we all know it's unconstitutional). Specifics, please. Cite Section(s) and Para(s). What are the tactics we need to use now? Groups to be pressured now? Methodology? Money? Feel free to add topics...that was just a starting point.
Okay, we now begin again....let's roll!
Who would have guessed. /sarc
Taxing jobs out of existence
By George F. Will, Published: May 9[...]
In 2010, however, Congress, ravenous for revenue to fund Obamacare, included in the legislation a 2.3 percent tax on gross revenue — which generally amounts to about a 15 percent tax on most manufacturers’ profits — from U.S. sales of medical devices beginning in 2013. This will be piled on top of the 35 percent federal corporate tax, and state and local taxes. The 2.3 percent tax will be a $20 billion blow to an industry that employs more than 400,000, and $20 billion is almost double the industry’s annual investment in research and development.
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Cook Medical is no longer planning to open a U.S. factory a year. Boston Scientific, planning for a more than $100 million charge against earnings in 2013, recently built a $35 million research and development facility in Ireland and is building a $150 million factory in China. (Capital goes where it is welcome and stays where it is well-treated.) Stryker Corp., based in Michigan, blames the tax for 1,000 layoffs. Zimmer, based in Indiana, is laying off 450 and taking a $50 million charge against earnings. Medtronic expects an annual charge against earnings of $175 million. Covidien, now based in Ireland, has cited the tax in explaining 200 layoffs and a decision to move some production to Costa Rica and Mexico.
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Unsurprisingly, Sen. Scott Brown (R-Mass.) supports repeal of the tax. Surprisingly, so does his opponent, Elizabeth Warren, an impeccably liberal Obamacare enthusiast who notes that in Massachusetts the medical devices industry has 24,000 employees and accounts for 13 percent of the state’s exports. Warren is experiencing another episode of New England remorse: “When Congress taxes the sale of a specific product through an excise tax . . . it too often disproportionately impacts the small companies with the narrowest financial margins and the broadest innovative potential.”
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When I read the article and saw Elizabeth Warren supports repealing the medical device tax, I was curious. On a campaign stop in Massachusetts, she said ...
Elizabeth Warren, Fair Play, and Soaking the Rich
I hear all this, oh this is class warfare, no! There is nobody in this country who got rich on his own. Nobody. You built a factory out there–good for you.
But I want to be clear. You moved your goods to market on the roads the rest of us paid for. You hired workers the rest of us paid to educate. You were safe in your factory because of police forces and fire forces that the rest of us paid for. You didn’t have to worry that marauding bands would come and seize everything at your factory.
Now look. You built a factory and it turned into something terrific or a great idea–God Bless! Keep a Big Hunk of it. But part of the underlying social contract is you take a hunk of that and pay forward for the next kid who comes along.
My question to Warren is, after your campaign pitch above, you want factories to pay a hunk of money, so why wouldn't you want Massachusetts medical device businesses to pay the additional tax. It's there to fund heatlh care reform isn't it?
Ahhhh. Because it will cost jobs. Reality bites, doesn't it.
Obama: HHS mandate prevents 'governemt meddling'
April 28, 2012President Obama suggested that his mandate that insurance companies provide free contraception is an effort to avoid "government meddling" in health care.
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Isn't the HHS mandate "government meddling" in the first place?
Again, you just can't make this stuff up.
Employers and insurers have long been at the forefront of changing the model of healthcare because of their concern with economics from a self-preservation view point, and, they didn't need totalitarian government to dictate every financial decision. Insurers can afford highfalutin attorneys and bean-counters to trim plans and budgets.
However, I stopped reading when I reached the following in the third sentence - "... America's 50 million uninsured..." this sounds suspiciously like the exaggerated claims made by Leftists.
Since the author's name sounded familiar I then Googled him and found plenty of evidence of his reliable Lefty bias here on NewsBusters, the most recent yesterday, April 24th.
What patients pay: Dr. Don Berwick and Jim Capretta debate shifting health care costs
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Dr. Don Berwick, former administrator of the Centers for Medicare & Medicaid, and Jim Capretta, who serviced as associate director at the White House Office of Management and Budget under President George W. Bush, took sharply different stances on what shifting costs to patients could mean during a wide-ranging debate last night hosted by the Pioneer Institute.
Berwick, now a senior fellow at the Center for American Progress, called the idea of giving patients more “skin in the game” a “vicious idea.”
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Capretta and Robert Moffit of The Heritage Foundation wrote recently in a National Affairs article that the Affordable Care Act should be replaced with a plan that gives more power to states and pushes consumers to pay attention to what their health care costs.
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Berwick, a fierce advocate of the Affordable Care Act, outlined a series of steps to lower costs in an article published online last month by the Journal of the American Medical Association. They include changing how doctors and hospitals behave so that they better coordinate patient care, increase transparency, and eliminate health care deemed unnecessary.
Berwick lauded a publication put out this week by nine medical specialists listing 45 procedures they said were ineffective, too costly, or did more harm than good. Their suggestions are “not trivial,” he said.
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From the above:
Berwick, now a senior fellow at the Center for American Progress, called the idea of giving patients more “skin in the game” a “vicious idea.”
I remember reading a certain item in President Obama's 2013 budget that I think relates to Berwicks statement. In the Department of Health and Human Services section, on page 112:
Encourages Beneficiaries to Seek High-Value Services.
The Budget includes structural changes that will help encourage Medicare beneficiaries to seek high-value health care services. To help improve the financial stability of the Medicare program, the Budget reduces the Federal subsidy of Medicare costs for those beneficiaries who can most afford them, and also introduces a modified Part B deductible for new beneficiaries beginning in 2017. To encourage appropriate use of home health services that are not preceded by inpatient care, new beneficiaries beginning in 2017 would be responsible for a modest copayment for home health services in certain cases. Research indicates that beneficiaries with Medigap plans that provide first dollar or nearfirst dollar coverage have less incentive to consider the costs of health care services, thus raising Medicare costs and Part B premiums for all beneficiaries. The Budget applies a premium surcharge for new beneficiaries beginning in 2017 if they choose such Medigap coverage. In addition, it strengthens the Independent Payment Advisory Board to reduce long-term drivers of Medicare cost growth.
It seems that the Administration wants Medicare home health service recipients to have more "skin in the game", something Berwick says is a "vicious idea".
You can't make this stuff up.
An interesting history of RomneyCare
How Deval Patrick Gutted Romneycare's Market-Oriented Health Reforms
On a side note, will history repeat itself? From the article, the author posits why Romney lost his 1994 bid to unseat Ted Kennedy in the Senate:
Romney didn’t win that election, in large part because he had not been prepared for a withering assault from Sen. Kennedy regarding his religious beliefs and his record at Bain Capital.
That may be so, Par, but a critical point that everyone should be aware of is what Romney said beginning at ~3:26 in the video on that web page. Combined with what the article states about what Romney wanted in/for MassCare and what the Democrats overrode him on and added to MassCare, it is reasonably feasible Romney sincerely means what he has been saying all along about RomneyCare and ObamaCare. I doubt even Romney is all robot to no not let slip his true thoughts during a heated exchange such as this with Kennedy (who had nothing of worth to say during the clip).
Frankly, this article and the accompanying video give me hope Romney will work to gut ObamaCare of at least some of it's onerous measures, if not agree to repeal the whole damned thing.
I hope Romney has learned how to deal with his past better this time. Obama will have both fanatics ready to believe whatever he says as Kennedy did, but also is sharper, gaffes and all, and more slippery than the reprobate Kennedy.
Looks like the Iowa Democrats were slapped down for their rhetoric.
Jury awards Sioux City lawmaker $231,000 in defamation suit
Friday, April 6, 2012SIOUX CITY -- A jury awarded Rick Bertrand $231,000 in damages late Friday after finding that his opponent and the Democratic Party committed libel and slander in a negative television ad in their 2010 race for an Iowa Senate seat.
Bertrand, a Republican, in October 2010 filed a lawsuit in Woodbury County District Court against his Democratic opponent at the time, Rick Mullin, and the Iowa Democratic Party, claiming he was defamed by a campaign ad that claimed Bertrand "put profits ahead of children's' health."
The Iowa Democratic Party paid for the ad, which was approved by Mullin. Jurors, who deliberated for more than four hours, ordered Mullin to pay $31,000 and the Democratic Party $200,000.
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New effort by MDs to cut wasteful medical spending
Apr 4, 3:15 AM
WASHINGTON (AP) - Old checklist for doctors: order that test, write that prescription. New checklist for doctors: first ask yourself if the patient really needs it.
Nine medical societies representing nearly 375,000 physicians are challenging the widely held perception that more health care is better, releasing lists Wednesday of tests and treatments their members should no longer automatically order.
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Dr. Christine Cassel, president of the American Board of Internal Medicine, said the goal is to reduce wasteful spending without harming patients. She suggested some may benefit by avoiding known risks associated with medical tests, such as exposure to radiation.
"We all know there is overuse and waste in the system, so let's have the doctors take responsibility for that and look at the things that are overused," said Cassel. "We're doing this because we think we don't need to ration health care if we get rid of waste." Her group sets standards and oversees board certification for many medical specialties.
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It's unclear how much money would be saved if doctors followed the 45 recommendations rigorously. Probably tens of billions of dollars, and maybe hundreds of billions over time. That would help, but come nowhere near solving, the problem of high health care costs.
The nation's medical bill hit $2.6 trillion in 2010. A major quandary for cost-cutters is that most of the spending is attributable to a relatively small share of very sick people. Just 5 percent of patients accounted for half the total costs among privately insured people, according to a recent study from the IMS Institute for Healthcare Informatics.
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No. Renewed effort, maybe, but not new except for some of the recommendations for FP's. This isn't the first time thrifty medical spending has been recommended.
FP and IM share only one recommendation which concerns acute low back pain. The recommendation is years old.
Two of the FP recommendations are relatively new. Treatment algorithms for acute sinusitus vary depending on the speciality doing the recommendation, but this is the latest and the greatest. The recommendation on Pap Smears is right out of the March 2012 USPSTF recommendations, the same group that created a stir with their 2009 mammogram recommendations. I find it interesting that the AAFP jumped on this barely month old recommendation without further investigation, let alone what ACOG, ACS, and other specialty groups think. My concern is the AAFP "deciders" are overwhelmingly comprised of Socialized Medicine fanatics and Obama-loving government lapdogs eagerly following Obama and Sebielus into the abyss.
Interesting
GOP plan would open FEHBP to non-feds
3/16/2012Republicans critical of Medicare have proposed an alternative that would open up the Federal Employee Health Benefits Plan to Medicare patients.
On Thursday, Sens. Lindsey Graham (R-S.C.), Rand Paul (R-Ky.), Jim DeMint (R-S.C.) and Mike Lee (R-Utah) introduced the Congressional Health Care for Seniors Act (CHCSA), a bill to add senior citizens to the FEHBP.
"We are going to offer a plan that would give all senior citizens in the country the same congressional health care plan that we have," Paul said, during the press conference announcing the bill. "We are not willing to wait until after the next election to fix the entitlements."
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I wonder if the crowd that was calling for "Medicare for all" will now be on board with "FEHBP for all", even though it appears Federal Employee Unions are going to oppose it:
Opposition from federal groups
Federal groups have expressed concern about the bill's impact on federal employees and their benefits if it became law.
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The president of federal union National Treasury Employees Union called the proposal a "disservice to the millions currently enrolled in Medicare and the more than 8 million federal employees, retirees and their families covered under FEHBP."
The bill would "threaten the stability of FEHBP and most likely result in higher premiums from the greater risks to their health and associated costs generally incurred by an older population," said NTEU president Colleen Kelley in a statement emailed to Federal News Radio.
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The article continues with a breakdown of the bill.
What Were They Thinking at Health Affairs?
Health Affairs is a peer-reviewed journal, which is why it was surprising to see it publish a recent article on the Massachusetts health reform, by Long et al [gated, but with abstract]. Based on telephone surveys, the authors declare that RomneyCare “continued to fare well in 2010.” This is an important finding, as the authors consider RomneyCare “the template for the federal Affordable Care Act of 2010.”
Unfortunately, in several cases the authors fail to inform readers that their results are contradicted by other, possibly more reliable, sources of information. They also neglect to put some of their results in proper context. Some examples:
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The author does a fair job of rebutting the conclusions of the article published in Health Affairs.
On a side note: I've been following John Goodman's Health Policy Blog for some time now. I highly recommend it.
In a blog about a transparency provision in the ACA, the Physician Payment Sunshine provision, the president of PhRMA thinks any new CMS rules should provide appropriate context regarding payments from Pharmaceutical companies to health care providers.
Transparency should bring clarity, not confusion
I was just wondering, where was PhRMA's concern about transparency when they were negotiating a behind-the-scenes deal with the Whitehouse to protect drug makers from bearing further costs in the overhaul.
White House Affirms Deal on Drug Cost
WASHINGTON — Pressed by industry lobbyists, White House officials on Wednesday assured drug makers that the administration stood by a behind-the-scenes deal to block any Congressional effort to extract cost savings from them beyond an agreed-upon $80 billion.
Drug industry lobbyists reacted with alarm this week to a House health care overhaul measure that would allow the government to negotiate drug prices and demand additional rebates from drug manufacturers.
In response, the industry successfully demanded that the White House explicitly acknowledge for the first time that it had committed to protect drug makers from bearing further costs in the overhaul. The Obama administration had never spelled out the details of the agreement.
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I would still like to know the details of the behind-the-scene deals PhRMA made with the Whitehouse. I'll take it, along with any context PhRMA would like to provide.
If PhRMA was as concerned about transparency back then as they are now, I'd take them more seriously.
Not to worry. Closed practices means fewer expenditures on patient care resulting in savings. Earlier death of "units" means additional savings Democrats can point to in future elections: "We're the Party of fiscal responsibility!"
The Democrats hope to squeeze out private entrepreneurship and funnel physicians and patients into Government owned and run factory clinics.
I recall some people saying that the individual mandate was a conservative idea, because Heritage had proposed a plan that contained an individual mandate. The following article was an eye opener. (h/t John Goodman)
Heritage and the Individual Mandate
By Peter Ferrara on 12.21.11
WASHINGTON (AP) -- The federal government is taking on a crucial new role in the nation's health care, designing a basic benefits package for millions of privately insured Americans. A framework for the Obama administration was released Thursday.
The report by independent experts from the Institute of Medicine lays out guidelines for deciding what to include in the new "essential benefits package," how to keep it affordable for small businesses and taxpayers, and also scientifically up to date.
About 68 million Americans, many of them currently insured, ultimately would be affected by the new benefits package. That's bigger than the number of seniors enrolled in Medicare.
The advisers recommended that the package be built on mid-tier health plans currently offered by small employers, expanded to include certain services such as mental health, and squeezed into a real-world budget.
They did not spell out a list of services to cover, but they did recommend that the government require evidence of cost effectiveness.
more from the AP here and because the AP are goobers who don't know how to link their sources... unfortunately you can't get the entire report without forking over some cash.
An short Interview with John McDonough:
Why IS Health Care Reform So Elusive?
John McDonough, HSPH professor of the practice of public health, was a senior adviser on the U.S. Senate committee responsible for developing the Patient Protection and Affordable Care Act, the landmark health care reform plan that President Barack Obama signed into law in March 2010. A former Massachusetts state legislator and executive director of the advocacy group Health Care for All, McDonough recently spoke with the Review about the revolutionary law, which he compares to the Social Security Act of 1935 and the Medicare and Medicaid Act of 1965. His new book is Inside National Health Reform.
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I was curious about this comment:
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Q: How does American public opinion break down on health care reform?
A: About half of the public—mainly Republicans—says that the law should either be completely repealed or substantially repealed. About half—mainly Democrats—says the law should be kept as is or strengthened.
Q: Does that suggest Americans have different core beliefs about the issue?
A: There is a broad shared sense—actually, bipartisan—that we spend much more on health care services than we would need to if we had an efficient, effective health care system. The difference is how to do that. For example, Democrats wanted to reduce Medicare spending by $450 billion over ten years and use those proceeds to pay for expanding coverage to the uninsured. Republicans don’t mind cutting Medicare by $450 billion—but they wanted to use the money for tax cuts. It’s not an argument over facts or data. It’s an argument, fundamentally, over values.
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Republicans don't mind cutting Medicare by $450 billion, but they wanted to use the money for tax cuts? Seriously?
Recession A Major Factor In Shift To Public Health InsuranceBOSTON — In the early years of Massachusetts health care reform, the motto was “shared responsibility.” It was the view that individuals, employers and state government all played in expanding coverage for the uninsured.
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In reality, shared responsibility for the uninsured in Massachusetts has quietly disappeared. The latest numbers show that virtually all Massachusetts residents who have gained coverage since the landmark 2006 law passed are now in a government health care program.
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Many experts agree the recession has played an enormous role in this shift from private to public coverage. Since the coverage law passed in 2006, 411,000 more residents of Massachusetts have health insurance; it’s the largest insurance expansion in the country. In the first few years, the expansion was fairly evenly divided between private and public insurance. That’s no longer the case.
According to Nancy Turnbull, an associate dean at the Harvard School of Public Health, “virtually everyone” of the Massachusetts residents who have received health care coverage with the implementation of the new law are enrolled in a public plan.
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Even so, Turnbull and others are worried about the consequences that expanded state health coverage will have on the state budget.
“The trend is certainly alarming and one state policymakers should take a closer look at,” said Josh Archambault, the director of health care policy at the Pioneer Institute. “We need to have a serious conversation about how we deliver our public insurance, because it means less money for education and less money for public safety. It’s going all into MassHealth at this point.”
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Off topic, but the format has changed, the latest comment is first, rather than last. And it appears we're not going to be able to have 300 comments per page.
This might take some time to get use to.
The question is, will they take the case.
State decides what's not an emergency
Published: 09/26/11 12:05 am[Washington] State government is about to start refusing to pay for repeat visitors to emergency rooms whose conditions don’t truly rise to the level of emergencies.
The trouble is all in how you define an emergency.
Starting Saturday, Medicaid won’t pay for more than three ER visits in a year for a patient’s nonemergency conditions as defined by the state. A list of more than 700 diagnoses put into that category has drawn fire from hospitals and doctors’ groups over inclusions whose symptoms seem awfully similar to emergencies:
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The state Health Care Authority sent letters to patients on Medicaid, the federal-state health insurance for the poor, warning them the government wouldn’t pay for their nonemergency treatment after three visits.
The agency is trying to save an estimated $72 million in federal and state Medicaid spending, as directed by state lawmakers who tried this spring to crack down on emergency room misuse.
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Many patients who are poor make the emergency room their first stop.
More than 46,000 times in fiscal year 2010, Washington ERs treated the conditions listed as nonemergencies for Medicaid patients who already had come in for three, four or even more similar visits that year, state officials say. One person visited 125 times.
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A followup.
SEATTLE, Sept. 30, 2011 /PRNewswire-USNewswire/ -- Emergency physicians in Washington State today filed suit in the Superior Court of Washington for Thurston County against a state plan that would limit payment for Medicaid visits to three "non-emergency" visits to emergency departments each year and classify more than 700 diagnoses as "non-emergent," including chest pain, abdominal pain, miscarriage and breathing problems.
"This list of non-emergent diagnoses puts patients in danger and unfairly targets the poor and those in most need of care," said Dr. Stephen Anderson, president of the Washington Chapter of the American College of Emergency Physicians. "We understand that our state Medicaid office is working with 19 other states to develop this policy. If this plan goes into effect, other states will certainly follow suit."
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Exactly how does this alter EMTALA and its current implementation and potential for litigation? Did I miss the section where the State or ObamaCare places new limitations on plantiff's attorney actions?
More supreme illogic from the Left. Implement a rationing program which puts patients, physicians and hospitals at risk, as well as community jobs and tax bases when hospitals are no longer able to operate, while having zero plan or capability to treat these patients otherwise. Simultaneoulsy, it increases the risk of missing a critical diagnosis by exerting a downward pressure to ration care, including patients waiting longer to seek help resulting in more expensive care required (or death, which is a much cheaper final solution for the State, Obama and Sebelius) while diverting blame for increased morbidity and mortality onto physicians and hospitals, not the State and Obama Administration where it belongs. (ObamaCare is driving these changes because it requires more expenditure by States on health care)
This decision is akin to the Left's penchant for implementing or increasing entitlement programs without funds to pay for it. In this case, the Obama Administration wants to decrease nonessential utilization of ER's, a worthwhile goal, but fails to implemented a plan in which these patients can get medical care other than in an ER.
Once again, the Left's good intentions will produce more pavement for the road to Hell. If the Republicans had a firing brain cell, they would talk nonstop on how the State and Obama Administration are not only abandoning the poor and at risk, but also how they want medical staff and hospitals to be unpaid slave labor put at greater risk, which may result in even fewer services, jobs, and tax dollars available to the community when staff or hospitals close or move away.
Basically, this is a shit sandwich without the bread.
bookmarking :)
As I recall, one of the very FIRST topics we discussed here, well over two years ago, was the database of medical records. With dire predictions, I might add.
Looks like our worst fears may be coming true.
Oh my. We were so smart, and now we are so screwed.
And the Feds will also have direct access to your bank account in order to make sure you pay the fine for not having health insurance.
Dean: Employers will drop coverage under Obamacare
Former Democratic National Committee Chairman, and doctor, Howard Dean backed a McKinsey & Co. survey today that found that almost a third of private-sector employers will drop their employee health insurance coverage when Obamacare's government-managed insurance exchanges come online.
Dean told Morning Joe, "The fact is it is very good for small business. There was a McKinsey study, which the Democrats don't like, but I do, and I think its true. Most small businesses are not going to be in the health insurance business anymore after this thing goes into effect."
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The Congressional Budget Office (CBO) premised their Obamacare score on the assumption that only 7 percent of employers would drop their employee health plans. If the percentage is closer to the 30 percent, as the McKinsey survey results predict, Obamacare's price tag would rise by almost $1 trillion.
Dean did confirm the dirty little secret: ObamaCare will cause businesses to drop health care thereby driving more population into government run health care exchanges. The more people turning to government to provide health care then the better. This is one of the incremental steps the Left had to settle on in their relentless drive for single-payer, exclusively government-run Socialized Medicine.
So it takes more bites to eat the apple. The American Left begrudgingly acquiesce playing by the long-run end game of fellow world Communists while hoping for another crisis, real or imagined, in order to advance their ideology more rapidly.
I say this because even Dean gets it or at least some of it and that is hard to believe. There is still the fact that many small business don't offer health benefits and will be forced to pay fines to stay in business and that will cost many apprenticeship and entry level jobs.
$1 trillion in government projection = $3.5 trillion in actual tax payer expenditures
The US is on its way to redefining the term broke! - not just financially though that will be the core problem.
And for Liberals - tax increases do not equal an increase in tax revenue just like tax cuts do not equal a decrease in tax revenue. It is the result of the action on the overall economy that dictates tax revenue.
And just like a typical dimwit, Dean could care less where that money, or those services will come from.
Are we not through with these flat earth cretins yet?
Son of SGR: Congress’s Medicare advisory panel made progress Thursday on draft recommendations for replacing the unpopular formula that Medicare uses to pay doctors. The Medicare Payment Advisory Commission is looking at a 10-year replacement that would likely cost around $200 billion.
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MedPAC’s draft alternative would replace the [SGR] automatic payment cuts with … different automatic payment cuts.
The proposal would freeze payment rates for primary care. All other services would take a roughly 6 percent cut for three years, followed by a freeze. Replacing the SGR with this SGR-ish alternative would cost about $200 billion, which would come from further cuts to healthcare providers.
California could pose problem for Obama's healthcare reform
September 15, 2011California, a model for healthcare reform, is seeking to impose some of the toughest limits on government-subsidized coverage. If approved, the limits could herald deep Medicaid cuts nationwide.
Reporting from Washington -- For more than a year, as conservative states have battled President Obama's sweeping healthcare law, California was supposed to be a model that showed the law's promise.
But the state is emerging as one of the biggest headaches for the White House in its bid to help states bring millions of Americans into the healthcare system starting in 2014.
Though still outpacing much of the nation, cash-strapped California is cutting its healthcare safety net more aggressively than almost any other state, despite billions of dollars in special aid from Washington.
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From the article, some of the waivers California is asking the Federal government for:
California already spends less per beneficiary than any state. It is now seeking waivers from the federal government to impose copays of $5 for office visits and prescriptions, $50 for emergency room visits and $100 for hospital stays. Few other states come close to charging Medicaid recipients that much.
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The state plans to limit Medicaid beneficiaries to seven doctor visits a year, with exceptions for essential care. No state has imposed such stringent limits.
California, which already pays Medi-Cal providers less than all but two states, also is pushing to cut payments to doctors, hospitals and others who serve Medi-Cal patients by 10%. That would drop reimbursement for a standard physician visit to less than $12.
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I just saw this article, and decided to post it, despite it being over a month old.
Cataracts, hips, knees and tonsils: NHS begins rationing operations
Thursday, 28 July 2011[...]
Two-thirds of health trusts in England are rationing treatments for "non-urgent" conditions as part of the drive to reduce costs in the NHS by £20bn over the next four years. One in three primary-care trusts (PCTs) has expanded the list of procedures it will restrict funding to in the past 12 months.
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The alarming figures emerged from a survey of 111 PCTs by the health-service magazine GP, using the Freedom of Information Act.
According to responses from the 111 trusts to freedom-of-information requests, 64 per cent of them have now introduced rationing policies for non-urgent treatments and those of limited clinical value. Of those PCTs that have not introduced restrictions, a third are working with GPs to reduce referrals or have put in place peer-review systems to assess referrals.
In the last year, 35 per cent of PCTs have added procedures to lists of treatments they no longer fund because they deem them to be non-urgent or of limited clinical value.
[...]
It surprised me that a health service magazine (GP) had to use freedom-of-information requests to get the information.
I don't like piling on, but, in this case, why not:
NHS makes patients wait 'to lower expectations’
11:36PM BST 04 Sep 2011NHS managers are making patients wait longer than necessary for operations, with one claiming that treating them quickly “raises expectations”.
At least 10 primary care trusts (PCTs) have told hospitals to increase the length of time before they see patients in order to save money, an investigation by The Daily Telegraph has found.
In some areas, patients endured delays of 12 or 15 weeks after GPs decided they needed surgery, even though hospitals could have seen them sooner.
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It comes after an NHS watchdog suggested that if patients are forced to wait a long time, they will remove themselves from lists “either by dying or by paying for their own treatment”.
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Par - I thought this was old news, years old. What is new? That it is the more locally managed PCT's doing the rationing instead of the monolithic, Jaba the Hut of a beast NHS?
Doesn't NHS still make the overarching rules and and disperse the budgets for the PCT's, who then divvy up the money as they see fit (as allowed by the NHS rules) for their localities? The PCT's have flexibility in how they spend their budgets but they are still slaves to the master NHS.
The PCT's perform 2 main functions: 1) Hopefully they spend money more wisely because they are more likely to be aware of local needs than the NHS, and 2) The NHS gets to blameshift at least some complaints about service and rationing onto the PCT's. Note the downward pressure on physicians to ration remains and in a sense is intensified because it occurs more on a local level.
Physician recruiter firm Jackson & Coker has released the results of a survey of physicians' opinions concerning the AMA. In a nutshell, ~75% of physicians believe the AMA does not represent them on a variety of issues including ObamaCare, tort reform, political machinations and more. Interestingly, the results are split between current, former and nerver was members of the AMA. Even the members of the AMA display a high prevalence of disapproval with the AMA.
None of this is a surprise to any physician I know and have previously discussed any aspect of this survey prior to it being published. What I did find humorous, though unsurprising, is that some physicians left the AMA because they thought it was too Right in its political ideology or did not support full blown CommieCare. Of course, overwhelmingly survey participants brroke from the AMA because of a Leftward bent, its support of ObamaCare, and, number one, the AMA no longer speaks for them.
I hope one of the NB writers pick up on this survey and publish an article in the Blog section.
Sam: No, I am not a member of the AMA. I realized in residency that the AMA concentrated more on non-physician issues. I thought they should split into a patient advocate group and a physician advocate group. The issue of a lucrative coding monopoly has been extant for years. Good to see it received more sunlight.
I appreciate AAPS's recognition of Hippocrates Oath on their home page. None of that new fangled, watered down, abortion on demand and euthanasia supporting, politically correct Lasagna version held so dear by today's progressive medical students and the AMA.
I did not know some hospitals required AMA membership! What was their reasoning?
Even if the hospital "pays" for it as part of your compensation package, I believe a physician has the right to decide with whom he'll be associated with professionally. I wonder if the reversal by these hospitals is more of an economic decision than right of association issue. Not difficult to guess.
Heritage Foundation published an article predating the J&C survey which discussed the discontent of students and physicians with the AMA. Maybe it was the impetus of the J&C survey.
Student discontent seems a little unusual from traditional attitudes since AMA membership is provided at no charge during medical school, at least when I was a student. No one knew much about the AMA at that stage and were happy to be a member of the traditionally respected group.
Who couldn't see this coming.
Health care expansion to cost Illinois, study finds
Sep 03, 2011Expanding Illinois’ Medicaid program under the federal health-care reform law will cost the state $1.3 billion a year in 2020 and beyond, according to an analysis by the nonpartisan Rand Corp.
The annual cost is at least six times higher than what state officials have estimated since the federal Affordable Care Act became law in March 2010.
[...]
HFS [IL Department of Healthcare and Family Services] officials had said the expansion would cost Illinois almost nothing initially, and only about $200 million per year in 2020 and beyond.
But the study by Rand, a respected not-for-profit research institute based in California, indicates that Illinois will incur about $700 million in new Medicaid costs not covered by the federal government in 2016. The cost to Illinois taxpayers would ramp up to $1.3 billion annually by 2020 and total $6.2 billion between now and 2020.
[...]
Off by more than a billion dollars a year, nothing new to see here, it's just a rounding error, move along.
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The following paper was linked to at the TaxProf Blog:
The author presents some good arguments (in my opinion) why hospitals shouldn't be non-profits.